On Nov. 13, 2012, plaintiff Oscar Wang, a twin, was born at 34 weeks at San Gabriel Valley Medical Center. Due to his prematurity, he was admitted to the neonatal intensive care unit. Two days after he was born, a nasogastric feeding tube was inserted to supplement his feeding. On the third day of his life, it was identified that Oscar had a distended abdomen. As a result, he was emergently transferred to Children’s Hospital Los Angeles, where emergency surgery was performed and it was identified that Oscar had a stomach perforation. The surgeon successfully repaired the hole in the stomach, and Oscar remained hospitalized for an addition 31 days for post-operative care. Luying Li, acting as Oscar Wang’s guardian ad litem, sued AHMC San Gabriel Valley Medical Center LP and AHMC Healthcare Inc. Li alleged that the nursing staff at San Gabriel Valley Medical Center was negligent in the care of Oscar, that the defendants’ were liable for the nursing staff’s negligence, and that this negligence constituted medical malpractice. Li also alleged that the defendants were negligent in the hiring, training and retention of their nursing staff. AHMC Healthcare Inc. was ultimately dismissed from the case early in the proceedings. Plaintiff’s counsel argued that AHMC San Gabriel Valley Medical Center failed to have the proper policies and training in place regarding the use of nasogastric feeding tubes. In particular, counsel argued that although the type of feeding tube used had changed nearly two years prior to the treatment of Oscar, the policies at San Gabriel Valley Medical Center were never updated and the hospital’s nursing manager admitted that no training was provided to the nurses on how to use a feeding tube after the initial orientation process. Plaintiff’s counsel argued that due to these failures, the nurses were negligent in their use of the subject feeding tube on Oscar. Specifically, counsel contended that the feeding tube was not secured properly and was allowed to move down two centimeters further into Oscar’s stomach shortly before the perforation occurred. Counsel contended that this movement caused an injury to Oscar’s stomach wall that contributed to the perforation. In addition, plaintiff’s counsel argued that the nurses failed to notice several abnormal vital signs that should have been red flags that Oscar was in distress and that despite these warnings, the nurses continued to administer feedings that were too large for a premature baby of his size. Thus, plaintiff’s counsel argued that the perforation was caused by a combination of damage from the feeding tube moving down and over-distention of the stomach from the over-feedings and that Oscar’s injury could have been avoided had the nurses compiled with the standard of care. Defense counsel argued that AHMC San Gabriel Valley Medical Center did not have a duty to update its policies or train the nurses because the use of a feeding tube is an everyday task in a neonatal intensive care unit. Counsel also argued that the nurses complied with the doctor’s orders and that the vital signs were always within normal limits and did not indicate a perforation was about to occur. Defense counsel further argued that the perforation was spontaneous and idiopathic, and that no one could explain what caused the perforation without speculating., After Oscar was diagnosed with a distended abdomen, he was emergently transferred to Children’s Hospital Los Angeles on Nov. 15, 2012. He was subsequently determined to have a stomach perforation and he underwent emergency surgery, which saved his life. Oscar remained hospitalized for 31 days for post-operative care and he was ultimately discharged on Dec. 15, 2012. Li claimed that following Oscar’s discharge from Children’s Hospital Los Angeles, Oscar experienced significant gastric reflux and constipation to the point that he only had bowel movements every three to four days. He claimed that Oscar’s symptoms continue nearly two years later. Li claimed that although Oscar’s reflux has improved, Oscar’s constipation has remained severe and consistent. Oscar’s parents claimed that they have tried using Lactulose, enemas, and dietary changes to help their child’s constipation, but that Oscar, now 2 years old, continues to experience frequent bouts of severe constipation. The plaintiff’s treating hospitalist and a billing representative for both Children’s Hospital Los Angeles and its physicians group testified that Oscar incurred $307,351.46 in past medical costs. Plaintiff’s counsel also asked the jury to award Oscar for his past and future pain and suffering. Defense counsel argued that the medical billing at Children’s Hospital Los Angeles was more than the reasonable value for the medical services in the community. Counsel also argued that Oscar’s current symptoms of gastric reflux and constipation were not related to the suffered from the gastric perforation and that these conditions, in particular the constipation, were idiopathic. Defense counsel further argued that babies experience pain in different ways than adults, that Oscar did not experience pain caused by the subject incident, and that any pain he did experience would not be remembered or have any effect on him in the future.